Individual
DIVINE NGANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDC I
Contact information
Practice address
30881 EKLUTNA LAKE RD, CHUGIAK, AK 99567-5166
(907) 793-3600
Mailing address
3600 SAN JERONIMO DR, ANCHORAGE, AK 99508-2870
(907) 793-3600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N.A
N.A
AK
Enumeration date
08/25/2020
Last updated
06/25/2025
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